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Referencias adicionales

Abrams 1979

Abrams PH,
Griffiths DJ.
The assessment of prostatic obstruction from urodynamic measurements and from residual urine.
British Journal of Urology 1979; 51(2): 129-34.

Bales 1999

Bales G,
Christiano AP,
Kirsh E,
Gerber GS.
Phytotherapeutic agents in the treatment of lower urinary tract symptoms: a demographic analysis of awareness and use at the
University of Chicago.
Urology 1999; 54: 86-9.

Exclusions: concurrent use of α-blockers; use of finasteride, phytotherapy within last 18 months or α-blockers within last
month; chronic prostatitis; previous bladder or prostate surgery; neurogenic bladder

Single-site study Randomization: randomized using balanced-blocks, where each block was for 6 men. Randomization codes were concealed in sealed
envelopes and opened only after last man had completed treatment Patients blinded; providers blinded

The American Urological Association Symptom Score Index, and the same score as the IPSS. These are self-rated, validated (i.e.,
symptoms that are confirmed clinically) questionnaires that measure the severity of irritative and obstructive urination symptoms.
There are seven questions with each question scaled from 0 to 5. A higher score indicates worse symptoms. There are seven
questions with each question scaled from 0 to 5. A higher score indicates worse symptoms.

BPH

Benign prostatic hyperplasia (BPH) is the nonmalignant enlargement of the prostate gland that is caused by an increase in
volume of epithelial (top layer of tissue that line cavities and surfaces of the body) and stromal (connective tissue) cells
into discrete, fairly large nodules in the periurethral (surrounding the urethra) region. These nodules in turn can restrict
the urethral canal causing partial or complete blockage.

Hyperplasia

The proliferation of cells (for BPH, the epithelial and stromal cells) within an organ beyond the ordinary.

IPSS

International Prostate Symptom Score. See AUA.

Peak urine flow

The maximum rate of urine as measured by a uroflowmeter.

Phytosterols

Steroidal alcohols that naturally occur in plants.

Phytotherapy

The use of plants, or plant extracts for medicinal purposes.

Serenoa repens

A small palm native to the American Southeast, Serenoa repens is popularly known as Saw palmetto. When used as a phytotherapy, it is often called Sabal serrulatum. It is the extract of its berries (fatty acids and phytosterols) that is used in the treatment of BPH.

TURP

Transurethral resection of the prostate. A catheter is inserted into the urethra up to the prostate to remove tissue by electrocautery
or sharp dissection.

Table 2. Summary table of adverse effects (SR vs placebo)

*SR

Placebo

Comparisons

P = 0.05

n / N (%)

Dizziness

10/349 (3) (1 trial)

1/56 (2) (1 trial)

P = NS

Gastrointestinal distress

30/665 (5) (2 trials)

3/169 (2) (2 trials)

P = NS

Headache

35/900 (4) (2 trials)

1/56 (2) (1 trial)

P = NS

Denominator is number in arm. *Serenoa repens. Per cents are rounded to the nearest tenth. NS = not statistically significant.

Table 3. Summary table of adverse effects (SR vs tamsulosin)

*SR

§TAM

Comparisons

P = 0.05

n / N (%)

Asthenia

10/349 (3) (1 trial)

10/354 (3) (1 trial)

P = NS

Decrease in libido

13/890 (1) (2 trials)

4/354 (1) (1 trial)

P = NS

Dizziness

10/349 (3) (1 trial)

6/354 (2) (1 trial)

P = NS

Ejaculation disorders

2/349 (1) (1 trial)

15/354 (4) (1 trial)

P < 0.05

Headache

35/900 (4) (2 trials)

37/354 (10) (1 trial)

P < 0.05

Postural hypotension

4/349 (1) (1 trial)

3/354 (1) (1 trial)

P = NS

Denominator is number in arm. *Serenoa repens. §Tamsulosin. Per cents are rounded to the nearest tenth. NS = not statistically significant.

Table 4. Summary table of adverse effects (SR vs finasteride)

*SR

¶FIN

Comparisons

P = 0.05

Decrease in libido

13/890 (1) (2 trials)

16/542 (3) (1 trial)

P = 0.06

Diarrhea

5/551 (1) (1 trial)

6/542 (11) (1 trial)

P = NS

Gastrointestinal distress

30/665 (5) (2 trials)

15/542 (3) (1 trial)

P = NS

Headache

35/900 (4) (2 trials)

2/542 (< 1) (1 trial)

P < 0.05

Denominator is number in arm. *Serenoa repens. ¶Finasteride. Per cents are rounded to the nearest tenth. NS = not statistically significant.